Valuable Vitamin D report bridges gap in bone health benefits

A new evidence report on vitamin D and bone health reviews the current scientific evidence and identifies its strengths and weaknesses. This report is a valuable resource that examines a range of scientific perspectives related to vitamin D and bone health across the lifecycle.

“This independent, systematic review is timely because there are mixed messages and recommendations to consumers regarding the benefits and harms of vitamin D intake” said NIH Office of Dietary Supplements (ODS) Director, Paul M. Coates, Ph.D. He added, “The evidence report in combination with the conference presentations and discussions, newly available methodological tools, and newer information on the vitamin D status of the US population will provide an invaluable and very timely update for the research and public health communities of what we know and what we need to know for this key nutrient.”

Researchers have long known that vitamin D had an impact on bone health but there is uncertainty about how much vitamin D is needed to achieve optimal bone health and whether there are differences in the relationship of vitamin D status to bone health across age and life stage groups. This report highlights the fact that the largest amount of evidence for bone health benefits is in postmenopausal women and older men (the majority over 60 years of age) taking vitamin D supplements. This report also confirms that vitamin D from ultraviolet-B (sunlight) exposure, fortified foods, or dietary supplements are all effective in raising the level of circulating vitamin D. Of concern, there were only sparse data on other subgroups cited as being at high risk for the consequences of low vitamin D, such as dark-skinned individuals and pregnant and lactating women.

The report found it difficult to define specific blood levels of markers for vitamin D status that indicate optimal levels for bone health. One reason for this is that current methods, which measure serum-25-hydroxy vitamin D as the marker for vitamin D status, yield highly inconsistent results. As part of its broader vitamin D initiative, ODS is working with laboratory testing facilities to standardize the quantification of vitamin D status.

The report investigators were not able to separate the impact of vitamin D from that of calcium, as most trials studied the effect of vitamin D plus calcium. The combination of vitamin D3 (daily dose 700 to 800 IU) and calcium (daily dose 500 to1200 mg) decreased the risk of falls, fractures and bone loss in the elderly (ages ranged from 62 to 85 years). The current recommended intake is 400 IU/day for people 51-70 years of age, and 600 IU/day for people over 70 years of age. Based on the combined data of two trials, the decreased risk of fractures was seen primarily in the subgroup of elderly women (average age 85 years) living in nursing homes.

Vitamin D intake above current recommended levels was not reported to be associated with an increased risk of harms. However, most trials using higher doses of vitamin D were not adequately designed to assess potential harms.

“The vitamin D and bone health evidence report provides valuable insights because it is based on an independent and rigorous examination of the totality of evidence across all age groups and during pregnancy and lactation,” said Agency for Healthcare Research and Quality (AHRQ) Director Carolyn Clancy, M.D. “It Is important that health care decisions are made using a review of all available evidence and not solely on the results of individual study reports.”

This report served as the framework for a conference, Vitamin D and Health in the 21st Century: An Update. The ODS-sponsored report was produced by the University of Ottawa Evidence-based Practice Center, and is available at:
http://www.ahrq.gov/clinic/tp/vitadtp.htm.

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Article adapted by MD Only Weblog from original press release.
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Contact:
Lisa Ahramjian
National Institute of Health

The mission of ODS is to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, stimulating and supporting research, disseminating research results, and educating the public to foster an enhanced quality of life and health for the U.S. population.

Smart Bone Cells May Add or Remove 3% Bone Mass Per Month

Liyun Wang, UD assistant professor of mechanical engineering, views osteocytes (bone cells) in her lab, as graduate students Wen Li and Xiaozhou Zhou examine the magnified images in the background.  Click here for more information.

Ten million people in the United States are estimated to already have bone diseases, and almost 34 million more are estimated to have low bone mass, putting them at increased risk for osteoporosis, according to the National Osteoporosis Foundation.

Liyun Wang, assistant professor of mechanical engineering at the University of Delaware, knows the serious consequences of osteoporosis.

Two of Wang’s aunts have suffered from the insidious bone-thinning disease, and one aunt died within a year after falling and fracturing her hip.

Wang is now leading research that will shed light on how osteocytes–the cells encased inside your bones–sense external stimuli and communicate with cells on the surface, signaling them to either build more bone or remove existing bone.

The five-year, $1.6 million project, ranked in the top 5 percent of research proposals recommended for funding by the National Institutes of Health (NIH) this year, holds promise in unveiling the mysteries of bone and joint diseases afflicting people worldwide.

The results may not only help scientists home in on the cause of osteoporosis and arthritis, but also develop more effective drug therapies to treat the debilitating bone and joint diseases.

The project will involve an interdisciplinary team of investigators at UD, including Prof. Mary C. Farach-Carson and Associate Prof. Randall Duncan, who hold primary appointments in biological sciences with joint appointments in mechanical engineering, and John Novotny, assistant professor of mechanical engineering.

“Bone and joint disorders affect almost half of all people over 50 years old, at a cost of $250 billion annually in the United States,” Wang said. “A third of the people who suffer a fracture due to bone loss end up dying within a year.”

The embedded bone cells, or osteocytes, that Wang is studying, act like the bone’s “brain.”

“The osteocytes are very smart,” Wang says. “They can tell whether a person is using his or her bones or not. If the person is physically active, the osteocytes tell cells on the surface that it’s okay to put on more bone. Otherwise, they signal the surface cells to remove bone at a rate that can be as high as 3 percent bone mass per month, which is the case for patients confined to long-term bed rest and for astronauts,” she notes.

The osteocytes lie in tiny pits or holes, called lacunae, within the bone. These living cells have many long arms that connect them to surface bone cells and the bone’s vascular system. The narrow channels housing the osteocyte’s arms (canaliculi) and the lacunae form a network through which a mixture of water, nutrients and other bioactive molecules flows.

“Although it is hard as cement, bone is actually like a stiff sponge,” Wang says. “It’s porous and has water inside. When we have mechanical loading, when you run, for example, a part of the leg bone is compressed, and water is pushed through gaps, less than a micrometer in size, between the osteocytes and the bone cement that surrounds them.”

This powerful wave of fluid keeps the osteocytes happy and functioning well, Wang says, delivering nutrients to them from nearby blood vessels and quickly dispersing signaling molecules, such as calcium ions, from one cell to its neighbors.

Using a novel microscopic imaging method that Wang developed, which is based on fluorescence recovery after photobleaching (FRAP), the research team hopes to do what no one has done before: see inside living bone and determine how rapidly these signaling and nutrient molecules are transferred between the cells when a bone is at rest and when it is at work.

A high-powered laser-scanning microscope will be used to assess the movement of molecules in the tibia of an anesthetized mouse. A harmless green fluorescent dye, tagged to various-sized proteins, signaling molecules and cell nutrients, will be injected into the animal’s bloodstream.

The dyed molecules will be subjected to a flash of intense light, temporarily photobleaching them black, leaving a distinct black sector surrounded by green. Thus, if the molecules diffuse into one another’s territories, they can easily be tracked by color.

Using similar techniques, Wang is investigating the communication between bone and cartilage in the development and progression of osteoarthritis, one of five projects in an $11 million NIH grant led by Thomas Buchanan, professor and chairperson of the UD Department of Mechanical Engineering. The UD effort includes a unique mentoring program for women scientists.

Wang says she is grateful for the mentoring and support she has received from her colleagues at UD since she joined the faculty in 2005, as well as from her doctoral advisers at the City College of New York, including Profs. Susannah Fritton, Steve Cowin, and Sheldon Weinbaum; and Dr. Mitchell Schaffler, with whom she worked as a postdoctoral researcher at the Mt. Sinai School of Medicine.

Currently, Wang’s laboratory group includes Wen Li, a graduate student in biomechanics and movement science, Xiaozhou Zhou, a graduate student in mechanical engineering, and undergraduate students Ben Keller and Laura Schultz, who are both working on degrees in mechanical engineering, and Samantha Nigro, who is pursuing her degree in biological sciences. Research associate Jun Pan will join the group at the end of this year.

“My students have been excellent,” Wang says, smiling. “They are well-organized and eager to learn how to do research. They are very motivated, and that is important. We have exciting work ahead of us!”

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Article adapted by MD Only Weblog from original press release.
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Contact: Tracey Bryant
tbryant@udel.edu
302-831-8185
University of Delaware

Wang is seeking two additional doctoral students and one postdoctoral researcher in the areas of biomechanics, orthopedic biology or mechanical engineering to join her research team. For more information, contact Wang at [lywang@udel.edu].

Osteoporosis affects more than 2 million men

According to the National Osteoporosis Foundation, osteoporosis affects more than 2 million men in the United States and nearly 12 million more have osteopenia — clinically significant low bone density that is less severe than osteoporosis.

Now, a new study from the University of Missouri-Columbia has found that men engaging predominantly in low-impact forms of exercise have an increased incidence of osteopenia — a condition resulting in two times the risk of bone fracture.

Unfortunately, some individuals who believe they are doing everything right in terms of their health might be surprised and upset by our finding,” said Pamela Hinton, an associate professor of nutritional sciences in MU’s College of Human Environmental Sciences, who co-authored the study. “We believe, however, that these results will ultimately serve as education and motivation for these people.”

Hinton said the effects of osteopenia can be mitigated by integration of weight-bearing activities into the lifestyle of active individuals. Studies in pre- and post-menopausal women suggest that bone mineral density will increase 2 percent to 3 percent after six months of resistance training three times per week. Small changes in bone density translate into much larger changes in bone strength — a 1 percent increase in bone density reduces the risk of fracture by up to 5 percent.

“Regular, non-weight-bearing activities, such as swimming and cycling are effective measures for preventing the leading risk factors for death and disability in our society,” Hinton said. “But the results of this study suggest that regular weight-bearing activities, such as running, jogging, or rope jumping, are important for the maintenance of healthy bones.”

The researchers measured bone mineral density in 43 competitive male cyclists and runners ages 20 to 59. Findings of the study included:

* The cyclists had significantly lower bone mineral density of the whole body, especially of the lumbar spine, compared to runners.

* 63 percent of the cyclists had osteopenia of the spine or hip compared with 19 percent of the runners.

* Cyclists were seven-times more likely to have osteopenia of the spine than the runners. Background facts:

* The risk of fracture is increased approximately two-fold in osteopenic individuals and five-fold in people with osteopenia.

* Low bone density in males often remains undiagnosed and inadequately treated and, after suffering a fracture, men are less likely to receive follow-up care than women.

* Risk factors for osteoporosis in men are similar to those identified in women: family history, age, low body weight, smoking, excessive alcohol consumption, inadequate calcium or vitamin D intake, low reproductive hormone levels, physical inactivity, and disease or medication affecting bone metabolism.

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Article adapted by MD Only Weblog from original press release.
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The study, “Participation in road cycling versus running is associated with lower bone mineral density in men,” will be published in Metabolism, and is authored by MU researchers R.S. Rector, R. Rogers, M. Ruebel and P.S. Hinton, in the Department of Nutritional Sciences.

Source: Jennifer Faddis
University of Missouri-Columbia

Nearly 50% of young women unaware Osteoporosis risk!

Many young women are unaware of the dangers of osteoporosis, leaving them vulnerable to crippling bone disease.

Mark J. Kasper, Ed.D., FACSM was the lead researcher for a survey of 302 college females enrolled in an elective physical activity course. While almost all (97.7 percent) had heard of osteoporosis, only 52.9 percent were able to correctly identify eight or more out of 14 risk factors listed and only 30.8 percent named all three major risk factors: low calcium intake, a sedentary lifestyle, and infrequent menstruation. The National Osteoporosis Foundation defines osteoporosis as “a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures, especially of the hip, spine and wrist.”

Kasper pointed out that 39.7 percent of respondents believed they were unlikely to develop osteoporosis. “Despite a similar lifetime risk of developing osteoporosis, heart disease or breast cancer, there is a lack of knowledge and a high degree of complacency concerning osteoporosis in young women,” said Kasper. “This data mirrors our previous research suggesting that educational interventions targeting young women either have not been implemented or have been ineffective.”

The coeds in Kasper’s study that osteoporosis is a serious illness, but less serious than heart disease or breast cancer. Blacks were less likely than whites to identify risk factors and to believe that they would develop osteoporosis. Respondents ranged from 18 to 21 years of age.

Exercise Aids Bone HealthPhysical activity is the only known intervention that can potentially increase bone mass and strength in the early years of life and reduce the risk of falling in older populations, according to a Position Stand from the American College of Sports Medicine (ACSM). The official ACSM pronouncement, published in the November 2004 issue of Medicine & Science in Sports & Exercise®, encourages the adoption of specific exercise prescriptions designed for various ages to best capitalize on the chances to accrue and preserve bone throughout the various stages of life.

The paper cites worldwide predictions that the number of hip fractures will double by the year 2025, with a mortality rate of 15 to 20 percent within the first year following such a fracture for elderly individuals, as reasons to encourage a better understanding of the types, durations and frequencies of physical activities that help build and maintain bone. These include high-intensity, high-impact activities for children to build bone and moderate-to-high intensity weight-bearing activities for adults to maintain bone mass.

For adults, experts have established these recommendations to help preserve bone:

Mode – weight-bearing endurance activities such as tennis and jogging, activities that involve jumping, and resistance exercise (weight lifting)
Intensity – moderate to high
Frequency – weight-bearing activities 3 to 5 times per week, resistance exercise 2 to 3 times per week
Duration – 30 to 60 minutes a day combined

For children, especially in the years surrounding the onset of puberty, experts recommend the following activities to help build bone:

Mode – impact activities such as gymnastics and jumping activities combined with moderate resistance training
Intensity – high, but with appropriate weights for resistance training (no more than 60 percent of the maximum amount a person can lift one time)
Frequency – at least three days per week
Duration – 10 to 20 minutes with multiple sessions within the same day potentially being more effective

The Position Stand also explicitly mentions the importance of bone health for men, noting that the predicted increase in osteoporotic falls and fractures in men in the coming decades is even greater than in women. The authors also encourage weight-bearing physical activities for even the most frail and elderly, provided they can still perform them safely.

The conclusions outlined in this news release are those of the researchers only, and should not be construed as an official statement of the American College of Sports Medicine.

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Article adapted by MD Only Weblog from original press release.
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Contact: Communications and Public Information
American College of Sports Medicine

Low Vitamin D Linked to Higher Risk of Hip Fracture

 Women with low levels of vitamin D have an increased risk of hip fracture, according to a study led by the University of Pittsburgh Graduate School of Public Health presented this week at the 29th annual meeting of the American Society for Bone and Mineral Research at the Hawaii Convention Center. Jane A. Cauley, Dr.P.H., professor of epidemiology, and colleagues evaluated patient data on 400 women enrolled in the Women’s Health Initiative Observational Study Cohort who had experienced hip fracture, confirmed by their medical record, over a median of 7.1 years. Levels of 25 hydroxyvitamin D, an indicator of vitamin D status, in the bloodstream were measured for these patients and compared with those of a control group matched for age, race, ethnicity and the date of relevant blood work. As vitamin D concentrations decreased, the risk of hip fractures climbed.“The risk of hip fractures was 77 percent higher among women whose 25 hydroxyvitamin D levels were at the lowest concentrations,” said Dr. Cauley, who has spent much of the past 15 years investigating the physical changes that take place in postmenopausal women. “This effect persisted even when we adjusted for other risk factors such as body mass index, family history of hip fracture, smoking, alcohol use and calcium and vitamin D intake.”Vitamin D deficiency early in life is associated with rickets – a disorder characterized by soft bones and thought to have been eradicated in the United States more than 50 years ago.

Though the exact daily requirement of vitamin D has not been determined, most experts think that people need at least 800 to 1,000 international units a day. Many experts believe the current recommended levels of 400 IUs daily should be increased.

The vitamin is manufactured in the skin after sun exposure, and is not available naturally in many foods other than fish liver oils. Some foods are fortified with the vitamin.

Dr. Cauley’s work also focuses on use of estrogen, risks of hip fractures, bone density and cholesterol levels of women who are going through menopause. As a co-principal investigator for the University of Pittsburgh’s site of the Women’s Health Initiative, a National Institutes of Health-sponsored study, Dr. Cauley and her colleagues continue to examine the effects calcium and vitamin D have on osteoporosis.

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Article adapted by MD Only Weblog from original press release.
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Contact: Michele Baum
University of Pittsburgh Graduate School of Public Health (GSPH)

Founded in 1948 and fully accredited by the Council on Education for Public Health, GSPH is world-renowned for contributions that have influenced public health practices and medical care for millions of people. One of the top-ranked schools of public health in the United States, GSPH was the first fully accredited school of public health in the Commonwealth of Pennsylvania, with alumni who are among the leaders in their fields of public health. A member of the Association of Schools of Public Health, GSPH currently ranks third among schools of public health in NIH funding received. The only school of public health in the nation with a chair in minority health, GSPH is a leader in research related to women’s health, HIV/AIDS and human genetics, among others.

For More Information About Supplementing Vitamin D Click Here

How Good Is Your Calcium Supplement?

Calcium is essential for many functions in the body, including:

• regulating the heartbeat
• conducting nerve impulses
• stimulating hormone secretions
• clotting of blood
• building and maintaining healthy bones.

Calcium is a mineral found in many foods. Getting enough of this nutrient is important because the human body cannot make it. Even after you are fully grown, adequate calcium intake is important because the body loses calcium every day through the skin, nails, hair, and sweat, as well as through urine and feces. This lost calcium must be replaced daily through the diet. Otherwise, the body takes calcium out of the bones to perform other functions, which makes the bones weaker and more likely to break over time.

Experts recommend that adults get 1,000 to 1,200 mg (milligrams) of calcium each day. Although food is the best source of calcium, most Americans do not get enough of it from food sources. Calcium-fortified foods (like orange juice, bread, cereals, and many others on your grocer’s shelves) and calcium supplements can fill the gap by ensuring that you meet your daily calcium requirement.

What to Look for in a Calcium Supplement

Calcium exists in nature only in combination with other substances. These substances are called compounds. Several different calcium compounds are used in supplements, including:

• calcium carbonate
• calcium phosphate
• calcium citrate.

These compounds contain different amounts of elemental calcium, which is the actual amount of calcium in the supplement. It is important to read the label carefully to determine how much elemental calcium is in the supplement and how many doses or pills to take.

Calcium supplements are available without a prescription in a wide range of preparations and strengths, which can make selecting one a confusing experience. Many people ask which calcium supplement they should take. The “best” supplement is the one that meets your needs. Ask yourself these questions:

• How well does my body tolerate this kind of supplement? Does it cause any side effects (like gas or constipation)? If so, you may want to try another kind or a different brand.
• Is this kind of supplement convenient? Can I remember to take it as often as recommended each day?
• Is the cost of this supplement within my budget?
• Is it widely available? Can I buy it at a store near me?

Other Important Things to Consider

Purity: Choose calcium supplements with familiar brand names. Look for labels that state “purified” or have the USP (United States Pharmacopeia) symbol. Avoid calcium from unrefined oyster shell, bone meal, or dolomite without the USP symbol, because it may contain high levels of lead or other toxic metals.

Absorbability: Most brand-name calcium products are absorbed easily in the body. If you are not sure about your product, you can find out how well it dissolves by placing it in a small amount of warm water for 30 minutes and stirring it occasionally. If it hasn’t dissolved within this time, it probably will not dissolve in your stomach. Chewable and liquid calcium supplements dissolve well because they are broken down before they enter the stomach.

Calcium, whether from food or supplements, is absorbed best by the body when it is taken several times a day in amounts of 500 mg or less, but taking it all at once is better than not taking it at all. Calcium carbonate is absorbed best when taken with food. Calcium citrate can be taken anytime.

Tolerance: For certain people, some calcium supplements may cause side effects such as gas or constipation. If simple measures (such as increasing your intake of fluids and high-fiber foods) do not solve the problem, you should try another form of calcium. Also, it is important to increase the dose of your supplement gradually: take just 500 mg a day for a week, then slowly add more calcium. Do not take more than the recommended amount of calcium without your doctor’s approval.

Calcium Interactions: It is important to talk with a doctor or pharmacist about possible interactions between your over-the-counter and prescription medications, and calcium supplements. For example, calcium supplements may reduce the absorption of the antibiotic tetracycline. Calcium also interferes with iron absorption. So you should not take a calcium supplement at the same time as an iron supplement – unless the calcium supplement is calcium citrate, or unless the iron supplement is taken with vitamin C. Any medication that you need to take on an empty stomach should not be taken with calcium supplements.

Combination Products

Calcium supplements are available in a bewildering array of combinations with vitamins and other minerals. Calcium supplements often come in combination with vitamin D, which is necessary for the absorption of calcium. However, calcium and vitamin D do not need to be taken together and/or in the same preparation in order to be absorbed by the body. Minerals such as magnesium and phosphorus also are important but usually are obtained through food or multivitamins. Most experts recommend that nutrients come from a balanced diet, with multivitamins used to supplement dietary deficiencies.

Getting enough calcium – whether through your diet or with the help of supplements – will help to protect the health of your bones. However, this is only one of the steps you need to take for bone health. Exercise, a healthy lifestyle, and, for some people, medication, are also important.

Source: NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases

Exercise Reduces Muscle and Joint Pain 25%

People who exercise regularly experience 25% less muscle and joint pain in their old age than people who are less active. Research published in Arthritis Research & Therapy reveals that people who regularly participate in brisk aerobic exercise, such as running, experience less pain than non-runners even though they are more likely to suffer from pain from injuries.

Bonnie Bruce and colleagues from Stanford University, USA, compared the level of pain in a group of runners and a group of community-based individuals who acted as controls. Participants were followed for 14 years, and were on average in their mid-sixties when the study started. Each year, they completed a questionnaire about their health status, exercise habits and history of injuries. In total, the study included 866 subjects: 492 Runners’ Association members and 374 controls.

Bruce et al.’s results show that the greater majority of physically active participants did, on average, between 355 and 2,119 minutes of exercise per week over the course of the study, while controls exercised significantly less. After adjusting for confounding factors such as gender, age, weight and health status the results show that pain increased in both groups over time. But members of the Runners’ Association experienced 25% less musculoskeletal pain than controls. This reduction persisted throughout the study period, until the subjects reached an age of 62 to 76 years.

“Exercise was associated with a substantial and significant reduction in pain even [...] despite the fact that fractures, a significant predictor of pain, were slightly more common among runners,” conclude the authors.

More research is needed to investigate the mechanisms that might underlie the effect of exercise on musculoskeletal pain in old age.

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Article adapted by MD Only Weblog from original press release.
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Aerobic Exercise And Its Impact On Musculoskeletal Pain In Older Adults: A 14-Year Prospective, Longitudinal Study
Bonnie Bruce, James F. Fries, Deborah P. Lubeck
Arthritis Research & Therapy 2005, 7:R1263-R1270 (19 September 2005)

Juliette Savin
press@biomedcentral.com
44-207-631-9931
BioMed Central
http://www.biomedcentral.com

Arthritis Research & Therapy (http://arthritis-research.com/) is published by BioMed Central (http://www.biomedcentral.com), an independent online publishing house committed to providing open access to peer-reviewed biological and medical research. This commitment is based on the view that immediate free access to research and the ability to freely archive and reuse published information is essential to the rapid and efficient communication of science.

Dietary calcium may prevent the spread of breast cancer to bone

A strong skeleton is less likely to be penetrated by metastasizing cancer cells, so a fortified glass of milk might be the way to block cancer’s spread, according to researchers at the ANZAC Research Institute in Concord, Australia. Using a mouse model of breast cancer metastasis, the researchers found that a calcium deficiency may increase the tendency of advanced breast cancer to target bone. Dietary calcium, they reason, might help prevent the spread of breast cancer to bone and serve as an adjuvant treatment during therapy.Their findings are presented in the Oct. 1 issue of Cancer Research, a journal of the American Association for Cancer Research.

According to the researchers, about 70 percent of patients who develop advanced breast cancer will have secondary tumors in the bone. The spread of cancer to bones leads to cellular processes that physically break down existing bone, leading to further pain and illness. In fact, the breakdown of bone and subsequent bone re-growth forms what senior author Colin R. Dunstan, Ph.D., terms a “vicious cycle” that turns bone into an environment conducive to cancer growth.

To better understand the role of bone turnover in the spread of cancer, Dunstan and his team compared the effects of a low- and high-calcium diet in mice. They found that dietary calcium deficiency – independent of the chemical factors that control turnover – was related to a significantly higher increase in cancer cell proliferation and the total proportion of bone that had been penetrated.

“These results could have implications for patients with breast cancer bone metastases or who are at high risk for developing metastatic disease,” Dunstan said. “Many older women in our community are known to be calcium deficient due to low calcium dietary intake or due to vitamin D deficiency. These women could be at increased risk for the devastating effects of bone metastases.”

According to Dunstan, his results call for further, directed clinical trials “to investigate how calcium and vitamin D status influence progression to metastatic disease, and to determine if corrections of calcium and vitamin D deficiencies are important in breast cancer patients.”

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Contact: Greg Lester
American Association for Cancer Research

The ANZAC Research Institute study was funded by the National Health and Medical Research Council of Australia and the New South Wales Government.

The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world’s oldest and largest professional organization dedicated to advancing cancer research. The membership includes nearly 26,000 basic, translational, and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and more than 70 other countries.

AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special Conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment, and patient care.

AACR publishes five major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention. Its most recent publication, CR, is a magazine for cancer survivors, patient advocates, their families, physicians, and scientists. It provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship, and advocacy.

Little Children Not Getting Enough Fiber

A Penn State analysis of the diets of a nationally representative sample of U.S. preschoolers, ages 2 to 5, shows that more than three-quarters of the children are not getting enough fiber.

Children who consumed the most fiber also had the most nutrient-rich diets. However, all children in the study ate fewer dairy servings than recommended by the Food Guide Pyramid.

Dr. Sibylle Kranz, assistant professor of nutritional sciences who led the study, says, “There is clinical evidence that children with low fiber intakes are at risk of chronic constipation. However, there are also other reasons to encourage fiber consumption in children. For example, fiber has been shown to lower cardiovascular risk in adults. Children who eat high-fiber foods are more likely to grow up into adults who consume adequate fiber.”

The study detailed in the Journal of the American Dietetic Association in a paper, Dietary Fiber Intake by American Preschoolers is Associated with More Nutrient-Dense Diets. (view abstract) The authors are Kranz; Diane C. Mitchell, Penn State Diet Assessment Center coordinator; Anna Maria Siega-Riz, associate professor of maternal and child health, University of North Carolina, Chapel Hill; and Dr. Helen Smiciklas-Wright, Penn State professor of nutritional sciences.

In the study, dietary consumption estimates were based on 2-day averages of 5,437 children whose parents provided information in the 1994-1996 and 1998 Continuing Survey of Food Intake by Individuals conducted by the U.S. Department of Agriculture. The researchers conducted separate analyses on the 2 and 3 year olds and the 4 and 5 year olds and compared them.

The younger children had, on average, a higher fiber intake than the older children. The two and three year olds, whose fiber intake placed them in the top quarter of the sample, met the new National Academy of Sciences Dietary Reference Intake level. These guidelines propose that Americans of all ages consume 14 g total fiber per every 1,000 calories based on evidence for reduced cardiovascular disease risk at that level.

The main fiber sources consumed by the children were, in order: low-fiber fruits, such as applesauce; legumes; and high-fiber cereal. Other low-fiber, low-nutrient foods that contributed very small amounts of fiber to the children’s diets included pizza and other high-fat, grain-based mixed dishes and high-fat salty snacks such as chips. High-fiber vegetables and fruit, which should be a major source of fiber, were consumed in too small quantities to contribute to the total average fiber intake.

“If parents feed their preschoolers fiber-rich foods, they are most likely providing important nutrients for the children as well,” Kranz says. “An easy substitution to get more fiber into their diets is to change to whole-grain products and high-fiber cereals. Also, children usually like sweet potato, baked beans, grapes and oranges and they’re all high-fiber, high-nutrient foods.”

The study was supported by a seed grant from the Penn State College of Health and Human Development.

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Source: Andrea Elyse Messer
Penn State

Children Don’t Drink Enough Milk

American children are drinking too little milk and what they are consuming is too high in fat, according to a Penn State study.”There is a strong correlation between dairy consumption and calcium,” says Sibylle Kranz, assistant professor of nutritional sciences. “While there is calcium in fortified orange juice, for example, it is not as bioavailable as that found in milk.” She notes that people need to take calcium with vitamin D and some protein for optimal use in the body.

Kranz, working with Po-Ju Lin, doctoral student and David A. Wagstaff, statistician, looked at children’s average daily dairy intake and compared it with that recommended by the U.S. Department of Agriculture’s My Pyramid dairy recommendations and Adequate Intake of calcium for various ages from 2 through 18. Their findings, reported online in press in the Journal of Pediatrics, are that only 2 to 3 year olds meet the MyPyramid dairy recommendations. They also noticed that most children choose to consume more of the highest fat varieties of cheese, yogurt, ice cream and dairy-based toppings.

The various recommendations for dairy intake in children established by a variety of organizations suggest two cups for 1 to 3 year olds, two to three cups for 4 to 8 year olds, and three to four cups for 9 to 18 year olds depending on the recommending agency.

Only the youngest age group met these requirements. Among 4 to 8 year olds, consumption dropped below two cups a day and remained steady for 9 to 13 year olds, and declined again among 14 to 18 year olds. All these dairy and calcium intake patterns were observed while the recommendation increased to three and then four cups daily.

“Although the recommendations are all for low fat dairy,” says Kranz. “People are still consuming great amounts of whole fat dairy products.”

The researchers found that 43 to 51 percent of the dairy consumed by younger children was from whole-fat sources with only 5 to 11 percent from non-fat dairy. Older children consumed about 35 to 36 percent from whole-fat dairy and 11 to 13 percent from non-fat dairy sources.

“A glass of fat-free milk has 80 calories, while whole milk has 150 calories,” says Kranz. “That is a difference per glass of 70 calories or 210 to 280 calories a day for individuals consuming three to four servings of dairy.”

The Penn State researcher notes that these additional calories can add to the current problems of childhood obesity. The difference between whole-fat and reduced-fat mozzarella cheese is 20 calories per ounce with another 30 calories if the cheese is fat free.

“While children are not meeting the diary or calcium requirements, it is not a good idea to try to meet them by eating premium ice creams or other high fat products,” says Kranz. She suggests frozen yogurts or sherbets or low or non-fat yogurt, cheese and toppings.

Also, researchers noted that dairy consumption patterns have not changed recently. Although physicians once recommended that children receive whole milk during the first year of life, that recommendation is no longer true. Doctors now recommend consumption of baby formula if the child is not nursing.

Starting with the second year of life, reduced-fat or fat-free milk is appropriate. However, children are still drinking whole-fat milk.

A cup of milk provides 250 to 300 milligrams of calcium, a cup of low-fat yogurt contributes about 400 milligrams of calcium and an ounce of cheese includes about 200 milligrams of calcium. In dairy products, about 32 percent of the calcium is bioactive and used by the body. Other sources of calcium such as soy milk and fortified orange juice at 300 milligrams are only about 25 percent available.

Dairy products in general are the best sources of calcium for children, but knowing this and getting children to eat more low-fat dairy options (yogurt, cheese and milk) are not the same thing.

Kranz suggests that one solution would be non-fat, non-sugared flavored milk products. These can range from milk with a little cocoa powder to milk blended with strawberries or blueberries.

Currently, only 9 percent of 2 to 3 year olds’ dairy consumption is flavored milk, 4 to 13 year olds drink more flavored milk –16 to 18 percent, while 14 to 18 year olds are at 13 percent.

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Article adapted by MD Only Weblog from original press release.
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Source: Andrea Elyse Messer
Penn State